1. Field of the Invention
The present invention relates, generally, to medical image records, and, more particularly, to modifying and routing DICOM image files with medical information to at least one or more sources.
2. Description of the Related Art
The Digital Imaging and Communications in Medicine (DICOM) standard was created by the National Electrical Manufacturers Association (NEMA) for improving distribution and access of medical images, such as CT scans, MRI and x-rays.
Accordingly, contemporary medical imaging uses the DICOM image format for the transport and storage of medical images. The DICOM image format arose in an attempt to standardize the image format of different machine vendors (i.e., GE, Hitachi, Philips) to promote compatibility such that machines provided by competing vendors could transmit and receive information between them. This original goal for the DICOM format has achieved varying degrees of success.
Over time, the DICOM standard has become the de-facto standard for the format used for medical images that are electronically transferred from one place to another. DICOM files have found particular use in the field of teleradiology. As used herein, the term “teleradiology” refers to, generally, the practice of reading a medical image at a location that is remote from the location where a medical examination was performed, or where the medical image related to the examination was acquired. Typically, the image is electronically transferred to the location where it is eventually read.
Teleradiologists (i.e., physicians who read and/or interpret medical images at a remote location) have encountered a major obstacle regarding images formatted according to the DICOM standard. Accurate interpretations of medical images require that the radiologist be aware of related patient information submitted by the referring physician. For example, a radiologist requires information regarding the patient's medical history, and perhaps information regarding the technologist and/or physician who performed the medical examination. The radiologist (and patient) will also benefit from having the referring physician's address, telephone and fax information readily available in order to communicate urgent findings or for use in secondary data feeds, such as the known Health Level 7 (“HL-7”) protocol. As known to those skilled in the art, HL-7 is a standardized data protocol for data transmitted within the healthcare industry. Unfortunately, such information is not typically available and teleradiologists often encounter an obstacle because they cannot interpret patient examinations accurately in a vacuum.
In the prior art, the DICOM image format provides for the entry of brief patient histories, usually by the technologist, and may also provide a patient work-list by the technologist that includes patient history and/or physician information. However, in practice, such information is often not provided or used as intended. This occurs, typically, because technologists who are time-constrained, tend to omit data entry tasks that they perceive as overly time-consuming, and they rationalize that the radiologist who eventually reads and interprets the medical image(s) already has or can gain access easily to the patient's chart should the radiologist require more information than provided in the DICOM file. Unfortunately this assumption is often false, especially in a teleradiology practice, when the patient's chart may be located hundreds or thousands of miles from the location where the teleradiologist actually interprets the medical image and/or examination.
Solutions to problems associated with a teleradiologist requiring more information than is provided in a DICOM file have, for the most part, taken the form of faxing or scanning handwritten clinical data (i.e., paperwork) to the teleradiologist. In the case of scanning, paperwork is typically entered in a flatbed or sheet-fed scanner and the scanned, electronic image(s) of the paperwork is uploaded to a computer, such as to a server configured to receive files via the file transfer protocol (“FTP”). The scanned paperwork can then be transmitted to a remote computer and made available to the teleradiologist.
Unfortunately, such prior art solutions are cumbersome and often untenable, especially in cases involving more than just a few patients. Accordingly, some prior art software vendors providing DICOM files have incorporated some type of image capture software in their software packages that provides for scanning, and electronically integrating the scanned material into the DICOM image file. This prior art software, however, is typically designed for capturing secondary medical images, and not paperwork. Also, such software can be quite cumbersome to use and require many complex steps. Further, technologists who operate medical image software programs vary widely in their abilities to use difficult software. Many are unable to use the software successfully for various reasons, including respective skill levels.
Most teleradiologists agree that an ideal scenario involves the simultaneous viewing of hand-written paper data when medical images are being viewed and interpreted. This is preferred over reviewing paper data, not as a separate task. To date, little has been done to facilitate this goal.
Moreover, it is recognized by the inventors that the transmission of DICOM image files that are transmitted in a DICOM communication session often include various errors, including data errors and data format errors, which complicate one's ability to receive and process a DICOM image file. Further, certain tag information is often incorrectly specified, such as a window and/or level value. Moreover, certain older CT and MRI devices incorrectly populate DICOM data fields. Too often, discovery of such errors occurs during processing of a DICOM image file, which contributes increased frustration and associated costs. Often, similar or the same errors are repeated by the same sending DICOM service class user.